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Article Abstract

Cognitive-behavioral therapy (CBT) is effective in the treatment of anxiety disorders when used in
conjunction with benzodiazepine pharmacotherapy and when used as a monotherapy. Patients using
CBT alone have dropout rates similar to or lower than those patients undergoing other forms of
therapy, including benzodiazepines. CBT also works well with patients who do not respond adequately
to pharmacotherapy. Combined CBT and benzodiazepine treatment has additive effects when compared
with benzodiazepine monotherapy; however, patients receiving combined therapy who subsequently
discontinue benzodiazepine treatment experience a loss of efficacy compared with CBT and
placebo, perhaps due to fear extinction being context dependent. To avoid this loss of efficacy, CBT
may be administered alone or as a bridge between benzodiazepine use and discontinuation during a
medication taper. The case report upon which this supplement is based questions the value of CBT for
patients experiencing cognitive impairment due to an anxiety disorder, benzodiazepine medication,
substance abuse, or a combination of these factors. This article addresses this concern and asserts that
CBT is a valuable treatment option in these cases.